Diseases and Cures Travel the Globe

Relatives and teachers need to keep up with findings about diseases in order to protect children. On the other hand, older students can begin to see career opportunities for themselves in medical and medical-related fields, including in the area of bioethics.

Tropical Diseases

Africa is breaking the grip of tropical diseases thanks to a coalition of aid agencies, pharmaceutical companies, and charities that formed Uniting to Combat Neglected Tropical Diseases (NTDS). Health programs in individual countries and radio programs where experts and patients answer questions about treatments and dispel misconceptions also do their part.
     In Sierra Leone, for example, a country once ravished by Ebola, health workers visit villages once a year to provide everyone at risk with drugs for four diseases:

• Elephantiases (lymphatic filariasis). Microscopic worms infest the body and cause extreme irreversible swelling and damage.
• River blindness (onchocerciasis). Blindness caused by black fly bites and worms infecting the body.
• Snail fever (schistosomiasis). Parasitic worm infection that destroys kidneys and the liver.
• (Helminths) Roundworms in soil cause infections that stunt growth and physical development.

By treating all family members with all four drugs at once, Sierra Leone saves money on multiple visits and prevents families from passing diseases to one another.

     Mosquitoes continue to be the ones that transmit malaria, dengue fever, and Zika in tropical areas. In warm, wet weather, they mature faster and become infectious sooner. But even in warm, dry conditions, they find ways to survive underground in storm drains and sewers. In Singapore on a small scale, Trendwatching.com reports innovative pots, decorated with paint infused with the non-toxic mosquito repellent, permethrin, are used to kill mosquitoes trying to survive in water collected in plant pots. (Use keywords, mosquitoes, malaria, dengue, and Zika, to find earlier posts on these subjects.)

Polio

News that polio is staging a comeback in some parts of the world recalls disturbing memories from my childhood. Paralysis from polio required President Franklin Roosevelt to wear leg braces, a neighbor to live in an iron lung, and a playmate to compensate for her withered left arm. When Jonas Salk's polio vaccine became available in the 1960s, we all rushed to take it on sugar cubes.
     Normally, the polio vaccine that carries a live, weakened virus breeds in the recipient's intestines and enters the bloodstream to cause a lifelong protective immune response. But occasionally, once in every 17 million vaccinations, the weakened virus mutates and causes a new strain that can live in poop for six to eight weeks following an innoculation. In countries that lack clean water, adequate toilets, and treatment for sewage, polio is transmitted by drinking water carrying the mutated virus. That seems to be what has happened to cause cases of polio in Papua New Guinea, Afghanistan, Pakistan, and Nigeria.

HIV/AIDS and STDs

Ever since the International AIDS Society (IAS) established a 90-90-90 goal in 2014, countries have aimed to make sure 90% of their population knows they have the disease, 90% of those are taking antiretroviral drugs (ARVs), and virus levels in 90% taking ARVs are negligible. Worldwide, only a 75-79-81 goal is reached.
      In less developed countries, HIV is combated by circumcising male foreskins to remove HIV-breeding cells and by paying school tuition for girls who are less susceptible to exchanging sex for food and other benefits, if they have employable skills. In all countries, HIV prevention responds to a combination of two ARVs, tenofovir and emtricitabine found in Truvada. Prevention still depends on those at risk coming forward and governments willing to help pay for treatment.
     After being raised and educated in Europe, Dr. Agnes Binagwano began returning to Rwanda with suitcases filled with medical supplies. Working with the government, she began an HIV program and trained health workers to visit villagers in their homes. To build trust for Rwanda's health care program, villagers chose the health workers who care for them.Once the country with the worst child mortality rate, 97% of Rwanda's infants now are vaccinated. The country where genocide killed nearly one million in 1994 also has the University of Global Health Equity in Kigali, rural health centers, and a nationwide health insurance program.
     Still a problem, ARVs give gay and bisexual men a false impression that these drugs prevent all sexually transmitted diseases (STDs). And birth control pills and other forms of female contraception give heterosexual couples the false impression male partners need not use condoms. Consequently, syphilis, chlamydia, and gonorrhoea infections all are on the rise from unprotected sex. At the same time, testing has been hit by cuts in funding for preventive education, local health departments, and confidential clinics that cater to adolescents.

Gene Editing

Which human cells the CRISPR-Cas9 technique edits and the changes made promise to treat diseases when engineered cells return to a patient's body. While unintended consequences of CRISPR-Cas9 editing to improve agricultural crops are less of a concern, the studies that find some forms of CRISPR-Cas9 editing delete or rearrange strings of DNA, affect non-targeted genes, and might cause cancer in humans motivate the search for technological techniques that produce only intended results.
     Genetic engineering capable of removing hereditary predispositions to cancer would, of course,be valuable. Editing into humans destructive hereditary traits passed along to future generations would not.
     Based on the way viruses can penetrate bacteria cells and destroy their defenses, CRISPR editing also is involved in the search for a way to k(ll superbugs resistant to antibiotics. (Use the keywords, antibiotics and CRISPR, to see earlier posts on these subjects.)

Cellphone Radiation

Research continues to study the danger of cellphone radiation from phones and antennas. Emissions from decaying lithium batteries, which remind me of those from black holes, also seem to indicate possible health risks. Keep an eye on findings about brain damage and memory loss from long term studies of new 5G technology. 

Technology's Hard Sell and the Public's Role in the Lithium-Ion Battery Industry

New technologies require public acceptance and industry risk takers. What if consumers had refused to bring nuclear-powered microwaves into their homes or to let doctors use lasers to cure diseases? I've gained new respect for the physics teacher I had who assigned students to weekly reports on journal articles describing break-through scientific advances. Unless a country enters the world's economy late or a hurricane or earthquake destroys infrastructure, it is an uphill slog for a new technology to compete with entrenched technologies.

     Top executives recognize the challenge of creating a corporate culture, much less a public culture, attuned to welcoming technological change. At a recent conference, CEOs of 100 leading companies in 17 different industries concluded it is easier to incorporate rapidly changing technology into an existing system than it is to create a corporate culture willing to embrace technological changes.

     Consider the introduction of lithium-ion batteries. In the United States, electric cars using these batteries need to compete with existing cars, and they require charging stations to replace gas stations. As a clean energy source, huge lithium-ion battery packs that provide power to electricity grids need to compete with coal and natural gas. When a leak at California's Aliso Canyon natural gas facility forced the San Diego Gas & Electric company and Southern California Edison to try to provide Los Angeles and San Diego with electricity from grid-scale batteries, AES Energy Storage built a lithium-ion battery installation in under six months, compared to the years it takes to obtain permits to construct polluting power plants near heavily populated urban areas.

     Logic suggests car manufacturers and electric companies avoid "marketing myopia" by seeing themselves with a wide lens that positions them in transportation and energy industries that need to invest in up-and-coming alternatives. Companies are beginning to do just that. AES and Siemens now have a joint venture. California Edison is working with Tesla, known for manufacturing electric cars, and Mercedes-Benz and BMW also are involved in stationary power storage projects with utilities.

     Nonetheless, reliance on private investment limits the development and use of lithium-ion battery technology. Again, there is a role for teachers and students who take a realistic view of what fosters technological advances. Denying the effect of fossil fuels on climate change does nothing to encourage government investment in clean energy from lithium-ion batteries or tax relief for battery manufacturers. And how about government support for lithium exploration (top producers are Australia, Chile, Argentina, and China) and safe disposal of used lithium or, better yet, support for efforts to "mine" recycled lithium?

     In fact, Elon Musk claims all the nickel used in his Tesla electric car batteries is reusable at the end of a battery's life. If true, that is good news, because nickel mining, mainly in Australia, Canada, Indonesia, Russia, and the Philippines, kicks up sulphur dioxide and pollutes rivers with oxidized nickel waste. Dr. David Santillo at Greenpeace's research laboratories reports crushing and transporting nickel produces dust containing copper, cobalt, and chromium, as well as nickel, that causes respiratory problems and cancer. Rather than continue to mine poorer and poorer strains of nickel, Santillo suggests an effort to recover and reuse nickel already extracted.

     Wise young people need to focus on the new career opportunities new technologies present.

Dump the Dump

You can feel superior to those who throw plastic bottles into the ocean, flip lithium batteries into the trash, and buy new shoes instead of having a cobbler replace worn heels. But a close look at recycling finds even this "solution" has problems awaiting solutions.

     Making it easier for soda consumers to recycle plastic bottles or providing batteries with electronic tags to help pull them out of the ordinary disposal process still sends these bottles and batteries to a waste plant. The problem of disposing of the heavy lithium-ion batteries that wear out in the growing fleet of electric cars is a major matter of concern to these auto makers as well.  Waste plants, such as the Integrated Waste Management Facility at Bukit Nanas in Malaysia, boast about converting waste to electricity, but they downplay the cancer and other toxic disease emissions these plants produce. And what about the average annual rate of 300 fires at waste and recycling plants in the United Kingdom?

     In a recycling industry where price to cost margins are small, there is little incentive to monitor air quality frequently, purchase sprinklers and other expensive fire prevention equipment, keep from stacking recycled materials too high and too close together, provide employees with protective gear, or penalize and shut down illegal waste sites.

     "Repair rather than replace" has a nice ring to it, but when it is less expensive to buy new shoes or a small appliance than to have old ones repaired or even find someone who can do the job, those options aren't considered.

     Knee jerk solutions aren't always solutions. Substituting degradable paper bags and packaging for plastic that requires fossil fuel to produce and years to disappear can deplete forests. Reducing the amount of gasoline cars use by adding 10% ethanol from corn requires more electricity and might mean some people go hungry.

     When I was having a chair reupholstered, I also asked the man I called to do the repairs how much it would cost to recover a sofa chewed by the cat. He told me, "$600." I said something like, "I've seen new sofas advertised for less." He asked how old my sofa was, and I guessed about 60 years. He told me I wouldn't find anything like its interior materials and construction on the market today and that he's recovered furniture for people who go to yard sales looking for old furniture they can buy cheap, because they know the insides of these old pieces are worth the cost of upholstering them.

     Every time we are walking to the trash to throw something out, maybe we should slow down and ask ourselves: what could I do with this, who could use this, why did I buy this in the first place?

   

The Challenge of New Technologies: Prepare to Think

IBM recognized what the future would require by showing the lack of space planned for the "K" slipping down the side of its "THINK" signs. The need to think was on display at last night's poster and presentation session given by high school students who spent their summer in science labs and departments at the University of Wisconsin.

     Students needed to be willing to expend a major effort just preparing for their experiments. One young woman dragged branches, plants, and flowers to the lab to find that birds need to be motivated by an attractive, secure area in order to breed. Multiple times a young man rowed a boat into the middle of a lake at night in order to scoop up water that showed what destroyed undesirable algae multiplied faster than the invasive species that destroyed the helpful algae remover. Another student had to find a sausage factory where he could procure the pig livers he needed to test how their properties changed during heating in a microwave. Various purifying procedures were needed before testing and careful math calculations were needed before a machine could emit radiation to attack tumors. Findings, such as the dangers of the toxic nano particles lithium batteries give off as they decompose, were preliminary but important.

     Heading into the future, artificial intelligence (AI); robotics, CRISPR and other medical technologies; the relationship of technology, human values, and public policy; and other technical subjects will play a major role in lives throughout the world. Yet in recent elections, electorates have cast their votes based on emotion: anger about the rich who are getting richer while they're not, anger about their countries filling up with people who don't look like them, and anger about a perceived attack on their values.

     Away from the disillusioned voters back home, members of the World Economic Forum (weforum.org) met in Dubai, United Arab Emirates, this week to discuss the impact of  new technologies. Their discussions need to make it back home to those have to understand how they will be affected by the good and bad impacts these technologies will have on their lives.

      However, you can't help but sympathize with anyone who tries to deal with the complexity and scientific jargon in an article about a technology, such as CRISPR-Cas9. First there is a description. CRISPR-Cas9 can genetically edit cells to improve crops and fight disease. In humans, if used to alter the genetic make-up of cells in an egg, sperm, or embryo, the same mutation will be transmitted from generation to generation. In order for the latter process to work, genes injected from outside need to be accepted by cells that store the germline, the biochemical unit of heredity.

     Then, articles tout the benefits of the new technology. Pig organs could be produced without the genes that prevent transplants in humans. Malaria-carrying mosquitoes could be eliminated the way genetically altered Atlantic salmon already grow double the size of ordinary salmon in half the time. Diseases could be cured, even though the complex interrelationship of genes often makes this unlikely in many cases.

     Articles frequently ignore problems associated with new technologies. It is up to the reader to ask, "Couldn't a rogue scientist use CRISPR-Cas9 to inject unhealthy mutations into human cells that would be transmitted from generation to generation?" Or might only wealthy people be able: to afford the cures that CRISPR-Cas9 technology could provide. While CRISPR-altered seeds produce uniform crops that can be harvested by machines, farmers in poor countries may not be able to pay for the annual purchase of patented hybrid seeds that grow food in drought conditions.

     Some call the biomedical duel between China and the United States to achieve dramatic CRISPR-Cas9 results "Sputnik 2.0." On October 18, 2016 scientists at Sichuan University in Chengdu, China, used CRISPR-Cas9 technology to see whether they could disable a gene in the patient's immune cells and reprogram the lung cancer patient's cells not only to resist but to fight back against the cancer. To date, results of the test are not known and neither are side effects. At the University of Pennsylvania in Philadelphia, Dr. Carl June also is about to use CRISPR editing to enable three genes in the immune cells of 18 cancer patients, who have not been helped by other treatments, to seek and destroy their cancerous tumors.

     Guarding against technology bias also needs to keep up with fast-paced artificial intelligence (AI) developments. Joy Buolamwini's Algorithmic Justice League found facial-analysis software was prone to making mistakes recognizing the female gender, especially of darker-skinned women. AI is developed by and often tested primarily on light-skinned men, but recognition technology, for example, is promoted for hiring, policing, and military applications involving diverse populations.

     Finally, we all need to think about and act on the guidelines, regulations, and other checks needed to keep up with the effects of rapidly progressing new technologies.